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耿×,男,6岁。因腹泻伴呕吐10小时入院。10小时前出现腹泻,大便稀黄,无脓血,每次约200毫升,共3次,同时伴呕吐5次,吐出胃内容物,病程中无发热。4个月前胸部X片示;心影增大。体验;体温,呼吸、脉搏正常。表情淡漠,扁桃体Ⅱ°,充血,颈软,心肺听诊(-),肝肋下2cm,质中。血、尿、大便常规正常。即给予静脉补液,口服山茛菪碱,SMZ治疗。次日上午呕吐、腹泻止。下午6时许患儿突然出现恶心,伴呕吐一次,继之出现意识模糊,面色苍白,大汗淋漓,四肢冰冷,脉搏细弱,心率18—24次/分,心律不齐,血压30/0mmHg,心电图示ST—T压低,完全性房室传导阻滞。拟诊心律紊乱,心源性休克。当即给吸氧,东茛菪碱1.2毫克静脉推注,5分钟1次×2,效不显。改东茛菪碱1.8毫克静脉推注,每10分钟1次×4,心率增至72次/分,心音有
Geng ×, male, 6 years old. Due to diarrhea with vomiting 10 hours admitted. 10 hours ago, diarrhea, stool thin yellow, no sepsis, each about 200 ml, a total of 3 times, accompanied by vomiting 5 times, spit out the contents of the stomach, no fever in the course of the disease. 4 months ago X-ray showed chest; increased heart shadow. Experience; body temperature, breathing, pulse normal. Indifferent expression, tonsil Ⅱ °, congestion, neck soft, cardiopulmonary auscultation (-), liver ribs 2cm, quality. Blood, urine, stool routine normal. That is given intravenous rehydration, oral anisodamine, SMZ treatment. The next morning, vomiting, diarrhea only. 6 pm children with sudden nausea, with vomiting, followed by blurred consciousness, pale, sweating, limbs cold, weak pulse, heart rate 18-24 beats / min, arrhythmia, blood pressure 30 / 0mmHg, ECG shows ST-T depression, complete atrioventricular block. Cardiac arrhythmias to be diagnosed, cardiogenic shock. Immediately to oxygen, scopolamine 1.2 mg intravenous injection, 5 minutes 1 × 2, the effect is not significant. Change scopolamine 1.8 mg intravenous injection, once every 10 minutes × 4, heart rate increased to 72 beats / min, heart sound